Hormone replacement therapy (HRT) has become increasingly widespread among mid-adulthood individuals who wish to regain optimized hormone levels and live a better life.
Besides traditional hormones taken orally or through injections, people can take HRT more easily through transdermal patches.
Is transdermal HRT better than oral or any other administration routes? Find out everything you should know about this treatment before you take it.
Transdermal HRT: Wellness That Comes in a Skin Patch
What Is Transdermal HRT?
Transdermal HRT is an administration route of hormone therapy that delivers hormones (estrogen, progesterone, testosterone) through the skin using patches.
Like other routes of hormone therapy (oral, injectable, pellets), transdermal HRT is prescribed to older women to manage menopause symptoms and to men who experience a decrease (either natural or due to a condition) in testosterone.
The menopause symptoms that transdermal HRT is approved to treat include:
- Hot flashes and night sweats
- Vaginal dryness and discomfort
- Mood swings and irritability
- Sleep disturbances
- Loss of bone density
- Cognitive changes
In men, transdermal HRT can be prescribed to treat or manage the following:
- Low testosterone (hypogonadism)
- Erectile dysfunction
- Bone loss (osteoporosis)
- Muscle loss
- Fatigue and low energy
Some typical transdermal HRT products include:
How Does Transdermal HRT Work?
Transdermal HRT works by applying a hormone-containing product (estrogen patch, progesterone patch, testosterone patch) to the skin (lower stomach area, below the waistline, or upper buttock area), allowing it to be absorbed directly into the blood.
Once applied to the skin, the hormones gradually diffuse through the skin layers and enter the bloodstream, providing a continuous and controlled release of hormones over time.
The specific application technique and dosage of transdermal HRT are determined based on an individual’s needs and existing hormone levels, and regular monitoring helps ensure optimal hormone balance and therapeutic outcomes.
A typical application technique and dosage of transdermal HRT may look like the following:
- Apply an estrogen patch (0.025 mg to 0.1 mg/day) or testosterone patch (up to 5 mg/day) once or twice a week.
- Apply a progesterone patch (up to 20 mg daily) for a specific duration each month, usually for 10 to 14 consecutive days.
- Change the patch at the same time each week.
- Rotate application sites to clean and dry skin areas.
Advantages of Transdermal HRT
Reduced Liver Metabolism
Transdermal HRT bypasses the gastrointestinal system and liver, which can result in more efficient hormone absorption and reduced metabolism compared to oral hormone therapy.
Steady Hormone Levels
Compared to the injectable route, transdermal HRT avoids hormone overdose and the complications caused by having too much hormone in the circulatory system.
Improved Safety Profile
Transdermal HRT has also been shown to be safer and cause fewer side effects than the oral administration route.
According to the Archives of Gynecology and Obstetrics, women with prothrombotic mutations had a 25-fold higher chance of developing venous thromboembolism (VTE) after oral HRT. In contrast, transdermal HRT had a 4-fold lower risk.
Enhanced Convenience and Adherence
Transdermal HRT allows users to adhere to the hormone regimen more sustainably due to its convenience and ease of use.
Unlike oral or injectable hormones, which can cause side effects that discourage adherence or require users to visit a healthcare provider’s clinic, transdermal HRT can be implemented anytime at home.
Who Should Take Transdermal HRT?
Transdermal HRT can benefit various individuals, particularly those who cannot tolerate oral hormone therapy or have a fear of injections or incisions.
If you fall under any type on the list below, transdermal HRT is for you.
Individuals With Gastrointestinal Intolerance
Some individuals may experience gastrointestinal side effects when taking hormones orally, such as nausea or indigestion. Transdermal HRT can be a suitable alternative as it bypasses the gastrointestinal system and reduces the risk of side effects.
Patients With Liver Impairment
Liver impairment can affect the metabolism and clearance of hormones, making oral hormone therapy less suitable. Transdermal HRT avoids first-pass metabolism through the liver, reducing strain on the liver and making it a safer option.
Fear of Injections or Incisions
Some patients may fear injections or surgical procedures involved in pellet implantation. Transdermal HRT offers a painless and non-invasive route of administration that may be more appealing to those with needle or incision phobias.
People Requiring Individualized Dosing
Transdermal HRT allows for individualized dosing adjustments, making it suitable for patients requiring precise hormone delivery and fine-tuning therapy. This quality can be crucial for patients with specific medical conditions.
Key Considerations for Transdermal HRT
Before starting transdermal HRT, being aware of several key factors is crucial. Here is a list of essential things to know before beginning transdermal HRT:
- Consult with a healthcare professional who specializes in hormone therapy
- Inform your healthcare provider about any medications, supplements, or medical conditions you have
- Understand the potential benefits and risks associated with transdermal HRT
- Be aware of possible side effects associated with transdermal HRT
- Your hormone therapy regimen should be tailored to your specific needs
- Understand the proper application techniques for transdermal HRT
- Regularly monitor your hormone levels to ensure optimal outcomes and safety
- Discuss with your healthcare provider any lifestyle modifications that may complement hormone therapy
- Understand that hormone therapy may be a long-term treatment
Success Stories of Transdermal HRT
Both estrogen and testosterone patches have been shown to offer superior treatment outcomes for menopause symptoms and sexual health in both women and men.
A study published by JAMA Internal Medicine shows that women treated with estrogen through the skin during early postmenopause experienced a modest improvement in sexual function. Specifically, compared to a placebo, estrogen patches were associated with improved pleasure, desire, lubrication, and orgasm at all time points.
In contrast, there was no apparent improvement in the total sexual function score between oral estrogen and placebo.
On the other hand, testosterone therapy through the skin is under investigation to help men and women in middle adulthood combat symptoms of low testosterone.
Remember that testosterone is vital in both genders and is equally crucial to sexual health in men and women. A recent article by Forbes has shown that British company Medherant is planning to produce a testosterone patch for menopausal women.
When the product is released, it could open a new approach to increasing testosterone and potentially remove unnecessary misery from women’s everyday lives.
Goldštajn M. et al. (2022). Effects Of Transdermal Versus Oral Hormone Replacement Therapy In Postmenopausal Women: A Systematic Review. Archives of Gynecology and Obstetrics.
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